NICE ‘n’ RICE

This is day 8 of my Adventures in Cellulitis, an extended occasion that has consumed most of my time and, one way or another, pretty much kept me from posting on this blog, Language Log, and AZBlogX. Specifically, “cellulitis of the hand” (the left hand, in this case), as the medical forms put it.

Cellulitis is a bacterial infection of the subcutaneous tissue, manifested in painful swelling and redness, and (usually) warmth to the touch, often spreading in a dramatically visible way through the lymph ducts, in red streaks emanating from the source location. The causative bacterium gets under the skin somehow or another, but as the Merck Manual (18th ed., p. 980) says, discouragingly:

Frequently no predisposing condition or site of entry is evident.

I had all the symptoms, they came on fast, Tuesday of last week, yet my affliction was (like most of the medical travails I’ve suffered in the last ten years) idiopathic. (Call me Arnold the Idiopath.)

A sense of crisis attended the whole business, because my last bout with cellulitis, back in 2003, involved not just the particular bacterium Staphlococcus aureus, but the resistant variety MRSA (pronounced like “mursa”), in fact MRSA gone rogue, run amok, transformed into the “flesh-eating bacteria” of journalistic fame: necrotizing fasciitis, a very nasty and life-threatening beast indeed.

Later I’ll post more on some of the details of cellulitis, its diagnosis, and its treatment, because the medical reference books say several linguistically interesting things. To allay any anxieties on my behalf, I can say that after I spent most of Monday (Labor Day in the U.S., Labour Day in Canada, my 70th birthday in these and other countries) in the Urgent Care facility of the Palo Alto Medical Foundation (a brief walk from my house), until a powerful antibiotic, #3 in a series of three so far, could be dripped into my veins, things have been looking up considerably: my left arm and hand are no longer in excruciating pain, the swelling and redness have pretty much disappeared. I’m still cross-eyed with exhaustion, though.

And the ordeal so far has set off a bad case of tennis elbow on the left. (You can call it tendinitis if you’d prefer to take a more formal stance towards the condition, or lateral epicondylitis if you want to get really stuffy, but it’s such an old acquaintance of mine — most often on the right, from my racquetball-playing days, but sometimes on the left, who knows why, and one awful time on both sides at once — that I address it by its street name.) So now in addition to the wrist splint to immobilize my hand, I now wear an elbow brace as well. Both in Brute Black, looking like items of S&M apparel; I should probably be scowling as I walk around town.

Which brings me to the mnemonic RICE — the orthopedists’ acronym for treating sprains and strains. All in verbs:

Rest
Ice (I’ve had an ice bag for this use for years)
Compress
Elevate

Rest: Yesterday I got to show off my newly-returned ability to wiggle my fingers without flinching in pain, at which point my doctor said sternly, “Great! Now don’t do that any more.” (Having learned to shift various activities from right hand to left after the NF disaster and the ulnar nerve damage that resulted from the surgeries, I’ve now had to learn to move them back to my damaged right hand. And to learn, with great awkwardness, to use my right hand for things I’ve done only with my left hand for many decades.)

Ice: I’ve had a cold pack for this use for years. Get the insert out of the freezer, slip it into the pack, and there you go.

Compress: The wrist splint does this as well as enforcing rest, and of course the elbow brace does this specifically.

Elevate: I suspect that sleeping with my left arm elevated — not a natural position at all — might have had a part in bringing on the tennis elbow, but I’m still doing E.

Now, mnemonics are wonderful, but they have their limitations. You have to remember which mnemonic goes with which purpose. And if they’re alphabetic mnemonics (acronyms included), you have to remember what the letters stand for. RICE gives me problems on both counts.

Even when I remember that RICE is the right mnemonic for orthopedic purposes, I don’t always recall what the R and the E stand for. This week no problem, since the whole routine has been much on my mind, but after a while the E will slip away, then the R, and all I’m left with is IC.

And at the beginning of the episode, I had to dredge up the acronym RICE. Being a linguist with a special interest in syntax and morphology, in general and in English, I’m more inclined to come up with NICE than with RICE.

NICE is the syntactician’s — especially the phrase structure grammarian’s — acronym for (some of) the most salient characteristics of English auxiliary verbs, characteristics that set them apart from main verbs. All in nouns:

Negation (with following not or n’t)
Inversion (in yes-no questions and other constructions)
Contraction (with a preceding word)
Ellipsis (of the complement: VPE)

For NICE, I’m forever forgetting the C, for a very good reason: only some of the English auxiliaries have contracted variants; can, could, may, might, and must, for example, do not.

But in any case, NICE interferes with RICE for me.

(This is a topic for another occasion, but: The status of the properties N, I, C, and E is an interesting, and surprisingly knotty, question. On the one hand, you might be inclined to think of them as mere symptoms of auxiliaryhood, the way redness, swelling, soreness, warmth, and streaks are symptoms of cellulitis, which crucially has a bacterial cause. But auxiliaryhood in English isn’t some sort of condition existing independently of its manifestations; there’s an important sense in which we talk about a class of Auxiliary Verbs in English only because of this constellation of morphosyntactic properties.)

And now the night draws on, and it’s time for me to get some R.

4 Responses to “NICE ‘n’ RICE”

  1. arnold zwicky Says:

    Comments from my Facebook link to this posting [Ned is the friend who sat with me through Monday’s medical routines]:

    Ken Callicott: One of my favorite medical acronyms is BRAT (bananas, rice, applesauce, toast) for the foods to eat after bad cases of diarrhea.

    Max Vasilatos: note that the BRAT diet recommendations have been superseded by probiotics, ie, active yoghurt cultures and electrolyte balanced drinks, in case anyone reading is going for advice herein

    Ned Deily: And probiotics after doses of intravenous antibiotics (/me recalls hearing something about this the other day).

    Arnold Zwicky: Ned is talking about the advice from the physician’s assistant at Urgent Care on Monday — advice that I did indeed follow by getting a probiotic on Tuesday. As the P.A. said, there’s a bewildering variety you can find over-the-counter.

  2. Greg Morrow Says:

    Get well, Professor.

  3. mollymooly Says:

    Since you didn’t have a happy birthday, I can wish you a happy belated birthday, to be cashed in at your convenience.

  4. GenX so in the funnies « Arnold Zwicky's Blog Says:

    […] Arnold Zwicky's Blog A blog mostly about language « NICE ‘n’ RICE […]

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